• Title/Summary/Keyword: Pain

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Fragmented Split-Thickness Skin Graft Using a Razor Blade in Burn Induced Diabetic Foot (화상을 동반한 당뇨발 환자에게 Razor Blade를 이용한 부분층피부조각 이식술의 효용성)

  • Park, Cheol-Heum;Choi, Manki;Kang, Chan-Su;Kim, Tae-Gon
    • Journal of the Korean Burn Society
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    • v.23 no.1
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    • pp.20-24
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    • 2020
  • Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.

Comparison of dexmedetomidine alone with dexmedetomidine and fentanyl during awake fiberoptic intubation in patients with difficult airway: a randomized clinical trial

  • Acharya, Ranjita;Sriramka, Bhavna;Koushik, Priyangshu
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.349-356
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    • 2022
  • Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

Anti-inflammatory activity of jakyakgamcho-tang on Lipopolysaccharide-Stimulated BV-2 Microglia Cells (LPS로 유도된 미세아교세포에서 작약감초탕의 항염증 효과)

  • Mun, Yeun-Ja
    • The Korea Journal of Herbology
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    • v.37 no.5
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    • pp.83-88
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    • 2022
  • Objectives : Jakyakgamcho-tang (JGT) has been traditionally used to treat muscular convulsion and pain in South Korea. According to recent studies, JGT has been reported to have anti-depression, anti-inflammation, anti-oxidative, anti-diabetics, anti-spasm and analgesic effects, but studies on its anti-neuroinflammatory and neuroprotective effect have not been deeply conducted. Thus, we investigated the anti-neuroinflammatory activity of JGT on lipopolysaccharide (LPS)-stimulated mouse microglia cells. Methods : To investigate the anti-neuroinflammatory effects of JGT on BV2 microglial cells, we examined the production of nitric oxide (NO) using griess assay, and mRNA expressions of pro-inflammatory cytokines such as interleukin (IL)-1𝛽, IL-6, and tumor necrosis factor (TNF)-𝛼 using real time RT-PCR. Furthermore, to determine the regulating mechanisms of JGT, we investigated the heme oxygenase (HO)-1 by real time RT-PCR. Results : Pre-treatment of JGT effectively decreased NO production in LPS-stimulated BV2 cells at concentrations without cytotoxicity. Additionally, JGT significantly suppressed the production of IL-1𝛽, IL-6, and TNF-𝛼 in LPS-stimulated BV2 cells. Furthermore, JGT activated the HO-1 expression, which is one of the immunomodulatory signaling molecules. And the abolishment of HO-1 by tin protoporphyrin IX (SnPP, the HO-1 inhibitor) reversed the anti- inflammatory activity of JGT in LPS-stimulated BV2 cells. Conclusions : Our results suggest that the JGT has anti-neuroinflammatory effect through the activation of HO-1 in LPS-stimulated BV2 cells. Thereby, JGT could expected to be used for the prevention and treatment of neurodegenerative disease related to neuroinflammation.

Treatment of Ankylosing Spondylitis (강직성 척추염의 치료)

  • Kang, Byeong-Jik;Jo, Sung-Sin;Park, Ye-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.294-304
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    • 2021
  • Ankylosing spondylitis causes ankylosis of the spine due to ossification of the articular cartilage and ligaments around the vertebral body as well as the sacroiliac joint. This pathophysiology limits joint movement and, in many cases, causes pain and deformity of the spine. If this disease is left untreated, it ultimately causes ankylosis and ossification of the whole-body joints. The symptoms generally develop before age 30 years, and the gradual progression of the disease adversely affects the physical function, professional ability, and quality of life. This increases the likelihood of developing psychiatric disorders, such as depression. The authors are aware of this severity and introduce recent trends and studies to prevent surgical treatment with various medications before systemic ossification. This paper presents various surgical treatments and complications in patients who were unable to prevent progression and underwent surgical treatment.

Acute Compartment Syndrome Induced by Rhabdomyolysis Due to Antipsychotic Drug Overuse (항정신병 약물 과량 복용 후 발생한 횡문근융해증으로 인한 급성 구획증후군)

  • Hwang, Seok-Ha;Hong, Sung-Ha;Suh, Seung-Pyo;Kim, Joo-Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.276-280
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    • 2020
  • A 49-year-old male was found unconscious at his accommodation and visited the emergency room. He was on antipsychotic and antidepressant drugs (vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, and alprazolam) for schizophrenia and major depression. At the time of discovery there were signs of overdose of the drugs around the patient. A physical examination revealed, pain, pallor, and edema in the left buttocks and lateral thigh. Active ankle movements below the left ankle were not possible and sensations in the tibia and peroneal nerves were lost. The pressure in the buttock compartment was measured at 42 mmHg. Magnetic resonance imaging revealed edema and high intensity signals in the left hip muscles and surrounding soft tissue. An emergency fasciotomy was performed and partial restoration of the lower extremity sensation and muscle strength were achieved after 24 hours.

Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture (병적 척추체 압박 골절 환자에서 경피적 풍선 척추 성형술 시행 후 발생한 마미 증후군)

  • Park, Sung Jun;Park, Myung Hoon;Park, Jae Woo;Cho, Kyu Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.90-94
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    • 2020
  • Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

Intrameniscal Gouty Tophus Originating from Medial and Lateral Meniscus (내측 및 외측 반월연골판에서 기시한 반월연골판 내 통풍 결절)

  • Park, Il-young;Kim, Young-mo;Joo, Yong-bum;Lee, Sang-bum
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.440-444
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    • 2021
  • In advanced gout, monosodium urate crystals are deposited in the joints and surrounding tissues, resulting in gouty tophi. A 45-year-old man was admitted to hospital due to pain and a limited range of motion in his right knee. Magnetic resonance imaging revealed a mass, and arthroscopic surgery and biopsy were then performed. Gouty tophi invading the anterior horns of the medial and lateral menisci were identified and surgically removed. To the best of the author's knowledge, there is no case report of intrameniscal gouty tophi invading both the medial and lateral menisci. This paper presents this case along with a review of the relevant literature.

Effects of Footwear Type on Ankle Muscle Activity during Sloped Walking (경사로 보행에서 신발의 형태가 발목 근육의 근활성도에 미치는 영향)

  • Jeong, Jae-Hyeon;Han, Yun-Ji;Choi, Jun-Ha;Jeong, Bo-Kyung;Ryu, Ji-Young;Yu, Jae-Hee;Lee, Sang-Yeol
    • PNF and Movement
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    • v.20 no.3
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    • pp.443-449
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    • 2022
  • Purpose: This study aims to identify the differences in the muscle activity of the ankle joint muscle depending on the type of footwear (sneakers, mule sneakers, slippers) worn while walking on a slope. Methods: The subjects wore each shoe (sneakers, mule sneakers, and slippers) and walked on an 18-degree slope at a speed of 110 beats/min. While walking, the muscle activities of the tibialis anterior and medial gastrocnemius were measured. Of the three walking cycles, the second walking cycle was measured except for the first and third walking cycles, which are the beginning and end, and a three-minute break was taken to prevent muscle fatigue when the type of footwear was changed. Results: When walking on a slope, there was no significant difference in the muscle activity of the tibialis anterior according to the type of footwear. However, when walking on a slope, the difference in muscle medial gastrocnemius muscle activity was significant between sneakers and mule sneakers. There was also a significant difference between sneakers and slippers, but there was no significant difference between slippers and mule sneakers. Conclusion: There was no significant statistical difference between sneakers and mule sneakers, but there was a numerical difference. Therefore, the presence or absence of the shoe collar may affect the muscle activity of the medial gastrocnemius when walking on a slope. This can lead to patellofemoral pain syndrome caused by the excessive use of the quadriceps, so it must be considered that caution is needed.

A Survey on Doctor of Korean Medicine's Recognition for Developing Korean Medicine Clinical Practice Guideline of Sanhupung (산후풍 한의표준임상진료지침 개발을 위한 한의사 인식 조사)

  • Kim, Yu-Been;Hwang, Su-In;Yoon, Young-Jin;Kim, Dong-Il;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.4
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    • pp.1-18
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    • 2022
  • Objectives: This survey was conducted to research Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung, and to use it as a basic data for the development of Korean Medicine Clinical Practice Guideline for Sanhupung. Methods: From October 1, 2021 to November 1, 2021, a self-administered questionnaire was conducted on an online survey platform targeting Korean Medicine doctors belonging to The Association of Korean Medicine, and the responses were analyzed. Results: Patients most commonly visited Korean Medical clinic within 22 to 42 days of miscarriage or childbirth, and the average treatment period was 1 to 3 months. To diagnose Sanhupung, Korean Medicine doctors most frequently identified the characteristic symptoms of Sanhupung, and the symptoms complained by Sanhupung patients were common in the order of arthralgia, coldness, feelings like wind coming in and muscle pain. For the treatment of Sanhupung, 94.8% of the respondents used herbal medicine, followed by acupuncture 78.1%, moxibustion 50.1%, cupping 29.5%, and Chuna 12.6%. For the prevention of Sanhupung, 81.8% of the respondents prescribed herbal medicine, and 66.4% of the respondents provided education to prevent Sanhupung. Conclusions: We researched the characteristics of Sanhupung patients visiting Korean medicine clinic and Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung and reflected them in the CPG for Sanhupung.

Electroacupuncture Treatment for Primary Dysmenorrhea: A Review of Randomized Controlled Trials

  • Jeon, Myung Kyu;Park, Jae Eun;Lee, Min Cheol;Kim, Hyeon Jin;Ahn, Jae Young;Shin, Na Young;Nam, Hye Jin;Chae, Go Eun;Jo, Hye Jeong;Kim, Hyun Woo;Lee, Young Jin;Koh, Arha;Kim, Woo Young
    • Journal of Acupuncture Research
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    • v.39 no.3
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    • pp.182-189
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    • 2022
  • To evaluate the effectiveness of electroacupuncture treatment for primary dysmenorrhea (PD), a literature review of a randomized controlled trials (RCTs) was performed where electroacupuncture was used as a treatment intervention in patients diagnosed with PD. Relevant clinical studies (N = 226) were retrieved from multiple databases according to the study inclusion/exclusion criteria, and interventions and outcomes were analyzed. As a result of the review, there were 6 RCTs which met the criteria. In all 4 studies that measured pain indicators (visual analog scales), electroacupuncture showed significantly positive changes. In addition, positive changes were observed in most indicators (MMDQ, PGF2a, PGE2, 6-keto PGF1, TXB2, clinical efficacy score, uterine arterial blood flow parameters, and blood viscosity). 2 studies showed that electroacupuncture had a stronger therapeutic effect than NSAIDs. No major side effects were reported. Electroacupuncture may be an effective and safe treatment for PD however, further RCTs are required.